Provider Demographics
NPI:1194388397
Name:WATTS, JOEL ANDREW (MS, LAT, ATC)
Entity type:Individual
Prefix:
First Name:JOEL
Middle Name:ANDREW
Last Name:WATTS
Suffix:
Gender:M
Credentials:MS, LAT, ATC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1081 HIGHLAND DR
Mailing Address - Street 2:
Mailing Address - City:MECHANICSBURG
Mailing Address - State:PA
Mailing Address - Zip Code:17055-6004
Mailing Address - Country:US
Mailing Address - Phone:717-514-8500
Mailing Address - Fax:
Practice Address - Street 1:1081 HIGHLAND DR
Practice Address - Street 2:
Practice Address - City:MECHANICSBURG
Practice Address - State:PA
Practice Address - Zip Code:17055-6004
Practice Address - Country:US
Practice Address - Phone:717-514-8500
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-04-15
Last Update Date:2024-09-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PART0077532255A2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer